Causes and treatment of a stiff lower back

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A complex structure of bones, joints, muscles, and other tissues makes up the back. A person may injure any of these bodily parts, which can cause pain and tightness in the lower back.

Trauma from a car accident, fall, or sports injury sometimes causes pain and tightness in the lower back. In other cases, injuries might occur while a person is performing a routine activity or everyday task.

Some other common causes of a tight lower back include:

• Herniated or ruptured discs: This is a flattening and bulging out or rupturing of the discs that sit between the vertebrae.
• Radiculopathy: This is inflammation, compression, or injury that affects a spinal nerve root.
• Sprains and strains: Sprains are the result of tearing or overstretching ligaments, whereas strains are tears in the muscles or tendons.
• Skeletal abnormalities: These include conditions such as scoliosis, lordosis, and other spinal abnormalities.
• Sciatica: This is a form of radiculopathy that involves compression of the sciatic nerve running down the back.
• Spinal stenosis: This is narrowing of the spinal column, which puts pressure on the nerves and spinal cord.
• Spondylolisthesis: This occurs when the vertebrae of the lower back come out of place and pinch nearby nerves.
• Poor posture: Spending extended periods in positions of poor posture can cause tightness and pain in the lower back.
• Arthritis: This is an inflammatory condition that affects joints throughout the body, including the back.

In less common cases, an underlying condition may cause tightness and pain in the lower back. Some potential causes include:

• tumors
• infections, such as discitis
• cauda equina syndrome, which is a rare, serious complication of a ruptured disc
• kidney stones, which form when crystals build up in the kidneys
• abdominal aortic aneurysm, which is a localized, abnormal enlargement of the main blood vessel passing through the abdominal cavity

Lower back tightness and pain can improve with stretching and other exercises that target the lower back.

It is best to talk to a doctor before starting a new exercise or stretching routine. They can offer advice on how to avoid any movements that cause pain or put excessive pressure on the back.

Some examples of exercises that may ease tightness include:

Lumbar rotation

According to the National Institute on Aging, this lower back exercise involves the following steps:

• Lie flat on the back.
• Stretch both arms out to the side, bend the knees, and keep the feet flat on the ground.
• With the shoulders, arms, and feet remaining on the floor, lower the knees toward the ground on the left, as far as possible without causing any discomfort.
• Hold the position for 20–30 seconds before moving the knees back to the center.
• Repeat on the opposite side.
• Do this 3–5 times on each side.

Cat and camel

According to the University Health Services at Berkley, CA, cat and camel stretches can reduce tightness and pain in the lower back. To perform the cat and camel:

• Start on the hands and knees.
• In one smooth, controlled motion, arch the back upward.
• Hold the position for few seconds and then slowly lower the back into an inverted position.
• Repeat this 10–15 times.

Single knee to chest

The single-knee-to-chest stretch can help stretch the lower back and legs:

• Lie on the back, with the knees bent and the feet flat on the ground.
• Pull one leg in toward the chest until there is a comfortable stretch of the back and hip.
• Hold the position for 15 seconds.
• Repeat on the other side.
• Do this 5–10 times with each leg.

Bridge pose

The bridge pose is common in yoga, and it can also help with lower back pain. To perform the bridge:

• Lie down on the back and bend the knees, placing the feet flat on the ground.
• Straighten the arms alongside the body with the palms facing upward.
• While keeping the shoulders, feet, and arms on the ground, raise the hips toward the ceiling.
• Hold for 4–5 seconds and then slowly lower the hips back to the mat.
• Repeat this 5–10 times.

Several other treatment options are also available. The standard first-line treatment involves over-the-counter medications and other therapies to treat the pain. Some options include:

• using analgesic medications, such as acetaminophen and aspirin
• taking nonsteroidal anti-inflammatory drugs, such as ibuprofen
• placing hot or cold packs on the lower back

In more severe cases, a doctor may recommend additional therapies. These could include:

• nerve block therapies, which cut off certain nerves in the lower back to help alleviate pain
• epidural steroid injections to provide immediate but short-term relief from pain due to conditions such as sciatica
• counterirritants, which are ointments and creams that help stimulate the nerves

If the problem persists, a doctor may recommend surgery. They are more likely to offer this treatment to people with back injuries that might need repairing.

Back pain and tightness are common problems, but it may still be possible to reduce the risk by:

• warming up and stretching before taking part in any sports or other physical activities
• avoiding smoking, which can affect blood flow and increase the risk of injury
• sleeping on a mattress that supports the spine
• exercising regularly
• wearing supportive and comfortable shoes
• lifting heavy objects with the knees and avoiding twisting the lower back
• eating a balanced diet
• reaching or maintaining a moderate weight
• avoiding long periods of inactivity
• maintaining good posture
• using lumbar supports

Most lower back problems will resolve without medical attention. However, if the pain persists for weeks, it is worth seeing a doctor.

If a person has sustained an injury to the back, they should see a doctor right away. The doctor can use X-rays and other diagnostic tests to check for damage to the joints, muscles, or ligaments.

Lower back pain and tightness are common complaints, and they have many potential causes, ranging from injuries to bad posture.

There are many exercises and stretches that can help with the pain. It can also help to take medications, such as pain relievers. Most cases will resolve on their own, but a doctor can help with persistent lower back problems.